Postpartum Hemorrhage Overview
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Questions and Answers

A new mother is experiencing unilateral breast swelling, redness, and tenderness, along with a burning sensation. She also reports a salty flavor in her milk. What condition is most likely causing these symptoms?

  • Sepsis
  • Wound infection
  • Endometritis
  • Mastitis (correct)

    • A nurse is caring for a newborn who is experiencing acrocyanosis. What actions should the nurse prioritize?

  • Monitor the newborn's respiratory rate and effort
  • Administer antibiotics to prevent infection
  • Perform a full skin assessment to rule out other skin conditions
  • Warm the newborn's hands and feet with a warm compress (correct)
  • Increase the newborn's fluid intake to promote hydration

    • What nursing intervention is considered essential for a postpartum patient experiencing endometritis?

  • Administer antibiotics and monitor lochia (correct)
  • Administer pain medication and monitor for fever
  • Ensure adequate hydration and encourage early ambulation
  • Provide perineal care with a peri bottle and warm water
  • Encourage frequent breast-feeding to promote uterine contractions

    • Which factor plays a significant role in the development of hypothermia in newborns?

    <p>Exposure to cold environments and evaporation of amniotic fluid (D)</p> Signup and view all the answers

    A postpartum patient is concerned about breastfeeding after being diagnosed with mastitis. What should the nurse advise the patient?

    <p>Continue breastfeeding as it does not harm the baby and helps clear the infection (A)</p> Signup and view all the answers

    Which nursing intervention is most effective in preventing wound infections in postpartum patients?

    <p>Maintaining a clean and dry wound environment (C), Providing education on perineal care, including the use of a peri bottle (D)</p> Signup and view all the answers

    What is a common symptom of sepsis in a postpartum patient?

    <p>Elevated temperature (E)</p> Signup and view all the answers

    Jaundice in a newborn is a result of:

    <p>The breakdown of excess red blood cells by the liver (A)</p> Signup and view all the answers

    What is a common emotional experience known as 'baby blues' characterized by?

    <p>Temporary emotional lability after birth (C)</p> Signup and view all the answers

    What is a significant risk factor for developing postpartum depression?

    <p>Previous mental health issues during pregnancy (A)</p> Signup and view all the answers

    What should be done to care for a newborn's umbilical cord stump?

    <p>Keep diapers rolled below the stump until it falls off (D)</p> Signup and view all the answers

    What is the recommended position for a car seat for a child up to two years old?

    <p>Rear-facing until two years old (C)</p> Signup and view all the answers

    Which of the following symptoms should prompt a caregiver to call a newborn's primary care provider?

    <p>A temperature greater than 100.4 F rectal (A)</p> Signup and view all the answers

    What is the recommended frequency for bathing a newborn in the first few weeks?

    <p>Three times a week is sufficient (B)</p> Signup and view all the answers

    What are signs indicating a need for immediate care for a newborn?

    <p>Foul-smelling discharge from the umbilical area (D)</p> Signup and view all the answers

    Which of the following describes a common behavior seen in younger siblings after the arrival of a new baby?

    <p>Regression in behavior due to divided attention (B)</p> Signup and view all the answers

    What clinical manifestation might indicate a newborn is experiencing kernicterus?

    <p>Seizures (C)</p> Signup and view all the answers

    Which diagnostic test is used to assess the presence of fetal antibodies in the context of Rh incompatibility?

    <p>Direct Coombs test (B)</p> Signup and view all the answers

    Which of the following is a sign of appropriate bonding between a parent and a newborn?

    <p>Affectionate actions (B)</p> Signup and view all the answers

    What bilirubin level in newborns within the first 24 hours is concerning?

    <p>Bilirubin &gt; 12 mg/dL (C)</p> Signup and view all the answers

    During which stage of maternal role attainment does a mother primarily focus on her own experiences after birth?

    <p>Stage 1: Taking in (A)</p> Signup and view all the answers

    Which of the following is considered a risk factor for delayed bonding between a parent and their newborn?

    <p>Young maternal age (D)</p> Signup and view all the answers

    Which of the following nursing interventions is crucial for managing hyperbilirubinemia in newborns?

    <p>Phototherapy management (A)</p> Signup and view all the answers

    What clinical manifestation could suggest a rapid breakdown of RBCs in a newborn?

    <p>Lethargy (D)</p> Signup and view all the answers

    At what age should cervical cancer screening begin using the Pap test?

    <p>21 years (C)</p> Signup and view all the answers

    How often should individuals aged 30-65 receive Pap tests if combined with HPV screening?

    <p>Every 5 years (D)</p> Signup and view all the answers

    Which family planning method involves tracking basal body temperature?

    <p>Natural family planning (A)</p> Signup and view all the answers

    What is the recommended timeframe for leaving a diaphragm in place after intercourse?

    <p>At least 6 hours but no more than 24 hours (C)</p> Signup and view all the answers

    Which of the following methods allows for family planning while exclusively breastfeeding?

    <p>Lactation amenorrhea method (C)</p> Signup and view all the answers

    What should be done before choosing a family planning method?

    <p>Obtain physical exam and discuss client preferences (B)</p> Signup and view all the answers

    What appearance does cervical mucus have during the fertile period?

    <p>Egg white appearance (A)</p> Signup and view all the answers

    What is the correct approach for using spermicide?

    <p>Placed 15 minutes before and lasts about an hour (C)</p> Signup and view all the answers

    What condition is a contraindication for the use of combined oral contraceptives?

    <p>Breast cancer (C)</p> Signup and view all the answers

    What is the maximum time a cervical cap should be left in place?

    <p>24 hours (B)</p> Signup and view all the answers

    Which of the following is a potential therapeutic effect of combined oral contraceptives?

    <p>Preventing acne (C)</p> Signup and view all the answers

    Which medication class can decrease the effectiveness of combined oral contraceptives due to their effect on liver enzymes?

    <p>Anticonvulsants (C)</p> Signup and view all the answers

    What is the primary action of progestin-only pills?

    <p>Suppress ovulation (B)</p> Signup and view all the answers

    What symptom should prompt a patient to seek medical attention while on combined oral contraceptives?

    <p>Leg pain (C)</p> Signup and view all the answers

    What is the recommended action if a patient misses two doses of their combined oral contraceptive?

    <p>Use alternative contraception and follow specific directions (D)</p> Signup and view all the answers

    The contraceptive sponge primarily works by which mechanism?

    <p>Physical barrier and chemical barrier (B)</p> Signup and view all the answers

    Which of the following is NOT a reason to switch or stop the use of combined oral contraceptives?

    <p>Mild migraines (D)</p> Signup and view all the answers

    What is the minimum duration a contraceptive sponge should be left in place?

    <p>6 hours (B)</p> Signup and view all the answers

    Study Notes

    Postpartum Hemorrhage

    • Cumulative blood loss greater than 500 mL after vaginal delivery, and greater than 1000 mL after C-section delivery
    • Early PPH: occurs within 24 hours of birth
    • Secondary PPH: occurs 24 hours to 6 weeks after birth
    • Clinical manifestations include a boggy uterus, possible deviation to the right, full bladder, and heavy vaginal bleeding with clots
    • Signs of hypovolemic shock (hypotension, tachycardia)

    PPH Causes and Interventions

    • Tone: Uterine atony (lack of contraction)
      • Interventions: Fundal massage, oxytocin medication
    • Trauma: Lacerations
      • Interventions: Repair of lacerations, suturing
    • Tissue: Retained products of conception (e.g., placenta)
      • Interventions: Surgical removal (e.g., D&C)
    • Thrombin: Coagulation problems
      • Interventions: Fundal massage, oxytocin medication, decrease blood loss

    PPH Treatment

    • Massage the fundus to contract the uterus and push down the vessels
    • Bimanual exam to apply pressure to the fundus
    • Medications: Oxytocin, Misoprostol, Methylergonovine, Tranexamic acid to increase clotting factors

    Other Postpartum Complications

    • Retained placenta: Placenta not delivered within 30 minutes, or significant blood loss before delivery. Manual removal or D&C is required.
    • Subinvolution of uterus: Uterus does not shrink, leading to continued bleeding.
    • Lacerations: Trauma to the perineal area requiring repair.
    • Hematomas: Localized swelling and pain, especially after C-section or vaginal delivery.
    • Deep vein thrombosis (DVT): Increased risk with C-Sections, requiring careful monitoring and treatment.

    Nursing Interventions

    • Expectant: Pain medication, ice packs for mild cases
    • Surgical: Vascular embolization, arterial embolization to stop bleeding
    • Postpartum Shock: Monitor vital signs (tachycardia, hypotension), provide fluids and oxygen support, possibly blood transfusions.
    • Endometritis (uterus infection): Monitor for fever, foul-smelling lochia. Administer antibiotics
    • Mastitis: Monitor for breast tenderness, warmth, or redness. Treat with antibiotics and pain relievers.
    • Wound care: Assess for redness, swelling, pain, and drainage at incisional sites

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    Related Documents

    Postpartum Hemorrhage (PPH) Unit 3 PDF

    Description

    This quiz covers postpartum hemorrhage (PPH), focusing on its definitions, causes, clinical manifestations, and interventions. Learn about the different types of PPH, signs of hypovolemic shock, and effective treatment strategies including uterine massage and medication. Enhance your understanding of this critical obstetric emergency.

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